| NPI | 1619113214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: TX 80492) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: MO 20008017910) |
| Enumeration Date | 2009-01-02 |
| Last Update Date | 2012-03-07 |